Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Oncol. Dec 15, 2012; 4(12): 259-264
Published online Dec 15, 2012. doi: 10.4251/wjgo.v4.i12.259
Colorectal cancer screening in human immunodeficiency virus population: Are they at average risk?
Suresh Kumar Nayudu, Bhavna Balar
Suresh Kumar Nayudu, Bhavna Balar, Division of Gastroenterology, Department of Medicine, Bronx Lebanon Hospital Center, Affiliated with Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10457, United States
Author contributions: Nayudu SK and Balar B designed the research and protocol, and prepared manuscript; Nayudu SK collected data and analyzed.
Correspondence to: Suresh Kumar Nayudu, MD, Division of Gastroenterology, Department of Medicine, Bronx Lebanon Hospital Center, Affiliated with Albert Einstein College of Medicine, Yeshiva University, 1650 Selwyn Avenue, Bronx, NY 10457, United States. sureshknayudu@gmail.com
Telephone: +1-718-518-5550 Fax: +1-718-518-5111
Received: May 31, 2012
Revised: September 7, 2012
Accepted: September 20, 2012
Published online: December 15, 2012
Abstract

AIM: To evaluate if human immunodeficiency virus (HIV) population is getting adequate screening for colon cancer in the highly active anti-retroviral treatment (HAART) era with improved longevity, and the prevalence of polyps and adenomas in this population, when compared with the general population.

METHODS: We conducted retrospective chart review of average-risk HIV population for colon cancer attending our infectious disease clinic. Individuals who underwent diagnostic colonoscopy were excluded. We extracted various demographic, HIV disease-specific and colonoscopy data including histo-pathological reports in the last 10 years. Total population was divided into a study group, who underwent screening colonoscopy and a control group who did not. We analyzed data using standard statistical methods and software.

RESULTS: We found that 25% of average-risk HIV-infected population was screened for colon cancer using colonoscopy. There was no difference in gender and ethnic distribution between the groups. We found wider distribution of age (50-84 years with mean 56 years) in the control group when compared to (50-73 years with mean 58 years) the study group. However, there were 89% of subjects with well-controlled HIV disease measured by HIV RNA copies of < 75 in the study group when compared with 70% in the control group (P < 0.0001). We noticed polyp detection rate of 55% and adenoma detection rate of 32% in HIV population.

CONCLUSION: It is unclear whether HIV or HAART medications play a role in increased prevalence of adenomas. We suggest that when estimating the risk for colonic neoplasms, HIV population should be considered as a high-risk group and screened accordingly.

Keywords: Colorectal cancer; Screening; Human immunodeficiency virus; Highly active anti-retroviral treatment